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20320
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES —USE BALL POINT PEN ONLY Building Pro ect Identification Building Addreaa, 10100 Torre Ave. Unit 120 (H1.1) PERMIT NO. 20320 Owner m: phone; Town Center Properties CITY OF CUPERTINO6BUILDING DIVISION APPLICATION'/PERMIT BUILDINC-ELECTRICAL PLUMSINC-MECHAMCAL 5/09/90 Contractors Name: LIc. No: 738-4444 CATEGORY CONTROLN Architect/Engineer. Lt. No: QTY ELECTRIC PERMIT FEE BUILDING PERMIT INFO Add.: © E9 K PERMITIS$UANCE 12 LICENSED CONTRACTOR'S DECLARATION I hereby hSmttmbmthat lam Bcen3oftheunder provisions of Chapter 9 IngweI. I. 11 formecat!deon3oflheBudnesssudlarofndonvCode, andm license le ie fuH force and effect. License Cho Llcp APPLIANCFSRF_4DENTIAL JOB DESCRIPTION J T���� `\] B t PANELS UP TO 2DO AMPS Date Contractor ARCHITECI'S DECLARATION I understand my plan a hag be used a public records. Licensed Pmfmabnl OWNER -BUILDER DECLARATION I hereby affirmthat I am exempt from the Contractor's License Law forthe following reason. (Section 7031.5, Business and Professions Code: Any city or munlywhkhrequiresaper ttommh Mater Impmw,dennlhh,orrepair anystm=mpAortoib Lwane,alsorequimlheapphnntfwsuchperrdtto file a signed statement that he is licensed pursuant to the provision of the Contractor'. License LAW (Chapter9(commencing with Section 7000) of Divi- sion3 of the Bushes m and PmfAkkx Code) m1hat heb exemtthm perefroand the basis for the alleged exemption. Any Wolation of Section 70315 by any applicant lora permit subjects the applicant to a dull penity of cast more thin five hundred dollars eSD0). ❑Lae owner of the property, or my employees with wage as their sole compenertlon, wlUclothe work and theshuMne, is not Intended or offered for sale (Sec. 704E Business and Profession Code: The Commemes License Law does not apply W an owner of property who build. or Improves l hermo, and who does such work himself or through hisown employees, provided that such Improvements are not Intended oroffemd for sale. If, however, the building or Improvement hmld wlthlnaneyearofcompletion,the owner-builderwill have tFBLIturcien of proving that he did not build or Improve for purpose of sale.). LJ L as owner of the property, am exclusively mntncting with licensed Wetncmn to mnbuct the project (Sec. 7014 Business and Profession Code: The Cmitncte. License Law don nut apply to an owner of property who Wilds builds or Improves thereon, and who contracts for such pio)ects with a cgR(fadorW licensed pursuant to the Contractor's License Law. LJ I am exempt under Sec B & P C for this reason 201-1000 AMPS OVER1000AMPS So FT. FLOOR AREA 805 $/SQ. FT. 74.92 SIGNSELECTRICAL S['ECIAL CIRCNT/MISC TEMP. MUMOR POLE INST. POWER DEVICES SWIMMING POOL ELECTRIC OUTLETS -SWITCHES -FIXTURES VALUATION y 60 s 311.00 $60,311.00 . NEW RESIDENTIAL ELECIR SQTr. STORIES TYPE CONSTRUCTION v—N TOTAL: QTY.' ,.PLUMBING PERMIT -.FEE OCC. CROUP R-3 RFS.UMTS / FLOOD TONE APN PERMIT ISSUANCE 12 ALTER -DRAIN A, WATER (EN FEE SUMMARY BACK FLOW PROTECT. DEVICE OUTSIDE FEES DRAINS. R DRAINFLOOR, ROOF, AREA, CONE). SANITARY Y N BBC= 0 Owner Date WORKMAN COMPENSATION DECLARATION bpp(TU(RES hereby of urn that I have a ceMifiuInure rc of consent to self-, or e cartificete of Workers• Compenadon lnurance cea certified copy thereof (See. 3800, fab C.) Policy N PER TRAP SCHOOLTAX Y_ N RECEIPT N GAS EA. SYSTEM -1 INCA OUTLETS PARK FEE Y_ N_ RDZEIPT # CAS EA. SYSTEM -OVER 6 (EA) Com any BUILDING DIVISION FEES S.ertNed copy b hereby furnished. � �C rtNed copy is flled'MtM1 the city ty inspection division, CERTIFICATE OF EXEMPTION FROM WORKERS' _ COMPENSATION INSURANCE IThlssectlon need net be complexed Bthe permit b forone hundred dollars 0100)caless3WATER.I.�W,/VErTT/eLECTR I mKilythat In the performanceof the work for which this permit is loved, I shall not employ any person In any manner n as to became subject to the Compensation laws of California. Date Applicant NOTICE co APPLICANT: after making this ationk ro of Exemption, you should ode,yo mus subject to the ply with Comp ruvislnprovhlonrmit of s Lab be Code, your ked. forthwith comply wltM1 eucM1 proWlon orthh permit shall be domed waked. CONSTRUCTION LENDING AGENCY Iherebyalli'mthat there is. mntructlon lending agency for the perform,TOTALo anw of the work for which this permit h Issued (Sec. 3097, Civ. C.) Iendela Name Lendee.Addres. I certlfythatl have read this•ppllcatlonand statethattheabovelnformatlon lamrmd. I dgreeto comply with all city and county ordinances and state laws relating to building mntmctlon, and hereby authorlee representativn of this city to enter upon theabove-mentiorud property for Inspection pu rpmes. (We) agree to save, Indemnify an d keep harmless the City of Cupertino against habNths,judgments, Wk. end expenwswhlch may In anywayaccue agalntsald tyince segue o M1e ming of this permit. , 2 Signature o(Applicant/Contractor Datli HAZARDOUS M RIALS DISCLOSURE Will theappH..t or future building occvpaMmme or handle haramous material as defined by the Cupertino Municipal Cade, Chapter 9.1 2, and the Health and SafetyCode Section 25532(a)7 ❑ Yes N No Wllllhe applicant orfuture building occupant use equipment ordevWs which coat havardous air contaminants as defined by IM Bay Area Air Quality Management District? YeA❑❑ No 4havcreadthe h.m..materialarequlrenormunderChapter6.95of the Calllemh Health & Safety Code, Sections 25505, 25533 and 25534. 1 understand that lithe building don not currently have a tenant, that it is my ponsibilitytonotifytheoccupantofthherequirementswhich=atbeout responsibility to notify the occupant of the requirements which =at be out Nor to Issuance of a Certificate ofOccupancy. GREASE/INDUSTRL WASTE INTERCEPTOR PLANCHECK FEE PAID Date Recti t# GREASE TRAP SEWER-y3My.ARy-STORM Eq 20mr1. ENERGY FEE Y N PAID Date Rece1 t# WATER SYSTEM/TREATINGWorkers NEW RESIDENTIAL PLMB. SQ.FT. TOTAL: BUILDING .E AAA nr SEISMIC FEE ELECTRIC FEE' Qr,Y:.. _,MECHANICAL PER FEE PLUMBING FEE MECHANICAL FEE PERMIT ISSUANCE 12 FEES PAID: 32.1 ALTER OR ADDTO MECH. Date Recei t# P AIR HANDLING UNIT (TO 10,000 CFM) SUBTOTAL: AIR HANDLING UNIT(OVER 10,00aCFM) CONSTRUCTION TAX EXHAUSTHOOD(W/DUCT) CONSTRUCTION TAX PAID: HEATING UNIT (TO 100,000 BTU) Date Recei t# HEATING UNIT (OVER 10,000 BTU) TOTAL: VENTILATION FAN (SINGLE RFSID) IS F'IaYL)DATE SUp �E, �_,A I , 1 90 s • ' Ott of Ctrnertinri ISSUED BY: M �-L•' BOILER -COMP DILPOR 100,000 BTU) BOILER -COMP (OVER 100,OWBTU) NEW RESIDENTIAL MECH. SQ.FT. ri Owner or authorised agent - Date TOTAL: OFFICE COPY